目的 探讨乌灵胶囊联合己酮可可碱注射液治疗神经性耳鸣的临床疗效。方法 研究对象选取2022年11月—2024年12月淄博一四八医院耳鼻咽喉头颈外科收治的108例神经性耳鸣患者，依据随机数字法将患者分为对照组（54例）和对照组（54例）。对照组患者静脉滴注己酮可可碱注射液，0.1g加入0.9%生理盐水100 mL中稀释，1次/d。治疗组在对照组治疗基础上口服乌灵胶囊，3粒/次，3次/d。两组用药2周。观察两组的临床疗效，比较两组治疗前后中医证候积分、耳鸣致残评估量表（THI）评分、匹兹堡睡眠质量指数量表（PSQI）评分、5-羟色胺（5-HT）、超氧化物歧化酶（SOD）、白细胞介素-6（IL-6）、γ-氨基丁酸（GABA）水平。结果 治疗后，治疗组总有效率是96.30%，显著高于对照组的81.48%（P＜0.05）。治疗后，两组听力下降积分、耳鸣如潮积分、耳中闷胀积分、神疲乏力积分均显著降低（P＜0.05）；治疗后，与对照组对比，治疗组中医证候积分均较低（P＜0.05）。治疗后，两组THI评分、PSQI评分均显著降低（P＜0.05）；治疗后，与对照组对比，治疗组THI评分、PSQI评分均较低（P＜0.05）。治疗后，两组IL-6、5-HT降低，而GABA、SOD水平升高（P＜0.05）；治疗后，治疗组IL-6、5-HT水平低于对照组，而GABA、SOD高于对照组（P＜0.05）。结论 乌灵胶囊与己酮可可碱注射液协同治疗神经性耳鸣效果较佳，能较好的改善耳鸣症状，减弱局部炎性反应，缓解患者睡眠质量，值得借鉴与推广。

Objective To investigate the therapeutic effect of Wuling Capsules combined with pentoxifylline in treatment of neurogenic tinnitus.Methods The research subjects were 108 patients with neurogenic tinnitus admitted to the Department of Otorhinolaryngology Head and Neck Surgery of Zibo 148 Hospital from November 2022 to December 2024. The patients were divided into control group (54 cases) and control group (54 cases) according to the random number method. Patients in control group were iv administered with Pentoxifylline Injection, 0.1 g was diluted in 100 mL of 0.9% physiological saline, once daily. Patients in treatment group were po administered with Wuling Capsules on the basis of control group, 3 grains/time, three times daily. The two groups were administered medication for two weeks. The clinical efficacy of two groups was observed, and the TCM syndrome scores, THI scores, PSQI scores, 5-HT, SOD, IL-6, and GABA levels before and after treatment were compared between two groups.Results After treatment, the total effective rate of treatment group was 96.30%, significantly higher than that of control group (81.48%) (P < 0.05). After treatment, the scores of hearing loss, tinnitus like a tide, ear fullness, and fatigue in both groups were significantly decreased (P < 0.05). After treatment, compared with control group, the TCM syndrome scores of treatment group were all lower (P < 0.05). After treatment, the THI scores and PSQI scores of both groups decreased significantly (P < 0.05). After treatment, compared with control group, the THI score and PSQI score of treatment group were both lower (P < 0.05). After treatment, IL-6 and 5-HT decreased in both groups, but the levels of GABA and SOD increased (P < 0.05). After treatment, the levels of IL-6 and 5-HT in treatment group were lower than those in control group, but GABA and SOD were higher than those in control group (P < 0.05).Conclusions The synergistic treatment of Wuling Capsules combined with pentoxifylline has a better effect in treatment of neurogenic tinnitus, and can effectively improve tinnitus symptoms, reduce local inflammatory reactions, and alleviate the sleep quality of patients. It is worthy of reference and promotion.

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山东省医药卫生科技项目（202304071680）